Should Filipinos be afraid of Zika?

With images of poor infants’s disturbingly misshapen heads bombarding us daily on international and local news shows, it’s quite easy to become paranoid in this age of pervasive media. And as numerous contrails crisscross the planet daily—to say nothing of land and water travel—one can make a case that the risk of epidemics and pandemics has never been higher.

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Zika, and its seemingly inexorable global journey, is now front and center in our collective psyche as we pose a question we dare not answer ourselves: How safe are we from the onslaught of the disease? Are Filipinos in the crosshairs of this mosquito-borne terror?

On its website, the Centers for Disease Control and Prevention (CDC) in the United States describes the Zika virus disease as being “spread to people primarily through the bite of an infected Aedes species mosquito.” Symptoms typically mirror that of the dreaded Dengue virus, acknowledged to be “a leading cause of illness and death in the tropics and subtropics” where it infects a staggering 400 million people yearly.

Although it surfaced fairly recently on our radar of concerns, the Zika virus was actually first discovered way back in 1947. It takes its name from Uganda’s Zika Forest near Entebbe, where first human cases were reported in 1952. Outbreaks subsequently occurred in tropical Africa, Southeast Asia, and the Pacific Islands.

“Both Zika and Dengue virus infections may present with fever, rash, muscle pain, or joint pain,” says Dr. Carmenchu Echiverri-Villavicencio, head of St. Luke’s Medical Center’s Infection Control Service at SMLC-Global City, in an exclusive interview with 2.O Magazine. However, it gets a bit tricky because only 20 percent of those infected will display symptoms, underscores Dr. Villavicencio. This is also another reason behind an underreporting of the disease. Aforementioned symptoms last from several days to a week.

“Prognosis is usually good,” assuages the doctor. “Guidelines are still being established if it is worthwhile to test asymptomatic patients who are pregnant due to concerns of microcephaly.” Microcephaly is a neurological disorder that causes the telltale, abnormally small heads in infants—resulting in brain damage or severe developmental issues, and sometimes even death. For the patient, Dr. Villavicencio says that the best course of treatment (following a hospital checkup, of course) is rest, hydration, and supportive treatment, which can be subsequently done at home.

Dr. Villavicencio cautions that although there “has been some association (established) between microcephaly and Zika,” the relationship “is not yet fully understood.”

The CDC is forthright on its public advisory. “We don’t know how the virus will affect her or her pregnancy. We don’t know how likely it is that Zika will be passed on to her fetus. We don’t know if the fetus is infected (or) if the fetus will develop birth defects. We don’t know when in pregnancy the infection might cause harm to the fetus,” it states. “We don’t know whether her baby will have birth defects. We don’t know if sexual transmission of Zika virus poses a different risk of birth defects than mosquito-borne transmission.”

The CDC reports that, in Brazil, another offshoot of the infection has been identified: Guillain-Barré syndrome (GBS). It is a potentially life-threatening, rapid-onset muscle weakness as the body’s immune system damages the peripheral nervous system. “GBS symptoms include weakness of the arms and legs that is usually the same on both sides of the body. In some cases, the muscles of the face that control eye movement or swallowing may also become weak. In the most serious cases, this muscle weakness can affect breathing, and people sometimes need a breathing tube to help them breathe.” The Brazil Ministry of Health has observed GBS in some people afflicted with Zika.

While the main culprit behind Zika is the Aedes mosquito, human carriers can also spread the virus in ways other than congenital infection. Villavicencio states that “sexual transmission has been reported, but the mode of transmission through this route is still unclear.” Zika may also be passed on through infected blood products. Nursing mothers can be comforted in the thought that there have been no reports of “transmission through breastfeeding.” The CDC concurs that infected men can spread the virus to their sex partners, and that a pregnant woman can pass Zika to her “fetus during pregnancy or at delivery.”

Notwithstanding conclusive evidence of the link, the apparent causality is spooking more and more couples into temporarily foregoing conception.

Health officials in El Salvador, one of the hardest-hit areas, advised women diagnosed with the virus not to conceive for two years, but Dr. Villavicencio avers that the “duration for delaying pregnancy who have been exposed or infected… is still uncertain. The virus may remain in the blood a few days to a week. Information (is still lacking) on the persistence of the virus in the blood after infection.”

So is there reason for Filipinos to be worried about Zika? Dr. Villavicencio replies: “I think instead of worry, what we should emphasize is Filipinos should be aware about this emerging infection… efforts are being done to control the spread of this infection.”

The Department of Health (DOH), in the wake of reports of cases in the country, is moving to increase the country’s state of readiness against the malady. Zika has now taken its place in the so-called Category 1 Classification of the Philippine Integrated Disease Surveillance and Response (PIDSR) System—joining the likes of other dreaded names like the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Ebola virus, and Influenza A (H1N1). “This means that all suspected cases of Zika virus diseases shall be reported within 24 hours to the Epidemiology Bureau (EB) through the Regional Epidemiology Surveillance Units (RESU) in the country,” DOH Secretary Janette Garin had said in a press conference.

To this end, the DOH has procured some 5,000 testing kits to conclusively identify Zika virus carriers among those highly suspected.

In SLMC, Dr. Villavicencio reveals: “Efforts are underway to create awareness among clinicians to equip them with knowledge in identifying individuals at risk, and those who need to be tested.”

For now, as neither vaccine nor cure exists for Zika, prevention is the only safeguard Filipinos can hope for. That means avoiding mosquito bites—particularly in the daytime as Zika virus-bearing mosquitoes are known to bite mostly during that time. Additionally, it means not having sex if you suspect yourself or your partner to have been exposed to the virus. “(Even if) persistence of the virus in semen has not been established, it is best that persons infected with the virus abstain from sexual intercourse and use proper protection to prevent conception,” states Dr. Villavicencio.

SLMC’s Infection Control Service head says we should shun flesh-baring clothes in the meantime, and advises to use mosquito repellant. Of course, at home we should take the same precautions we already know so well to curb the increase of the mosquito population. Be mindful of stagnant water around you, and spray insecticide in suspicious areas.

As for pregnant women, the doctor suggests to “consult a doctor for evaluation and proper guidance,” particularly if they have recently visited a country where the Zika virus is.

So, as the world continues to grapple with and learn about Zika, the old adage remains as relevant to us all: An ounce of prevention is worth a pound of cure.